Emerging problems of heart failure practice in Japanese women: lessons from the CHART study.
BACKGROUND
The prognosis of patients with chronic heart failure (CHF) is poor in both men and women. However, the characteristics of, and effective treatment strategy for, female CHF patients still remain unclear. This study was designed to evaluate the prognosis and characteristics of female patients in a CHF cohort termed the Chronic Heart Failure Analysis and Registry in the Tohoku District.


RESULTS
Of 1,278 patients registered in the cohort, the study population comprised 1,166 symptomatic CHF patients with sufficient data. As compared with male patients, female patients were more likely to be older, have preserved systolic function and non-ischemic etiology of CHF, and underuse standard CHF medications. Although a previous study showed that sex-difference was not a significant prognostic factor in CHF patients, the unadjusted survival analysis revealed an increased event rate in female patients in the present study. Multivariate analysis revealed that older age, diabetes, ventricular tachycardia and anemia were significant prognostic risks in both men and women with CHF.


CONCLUSIONS
Female sex had a significant link with elderly CHF patients. Given the explosive increase in elderly patients in Westernized countries, further studies are needed to elucidate the evidence for treatment of female CHF patients.
Shiba
Nobuyuki
N
Department of Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan. nshiba@cardio.med.tohoku.ac.jp
Nochioka
Kotaro
K
Kohno
Haruka
H
Matsuki
Mika
M
Takahashi
Jun
J
Tada
Tomohiro
T
Kagaya
Yutaka
Y
Shimokawa
Hiroaki
H
D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000150:complications; D044466:Asian People / Q000706:statistics & numerical data; D002309:Cardiology / Q000706:statistics & numerical data; D002317:Cardiovascular Agents / Q000627:therapeutic use; D002908:Chronic Disease; D048909:Diabetes Complications / Q000628:therapy; D004363:Drug Utilization; D005260:Female; D019538:Health Care Surveys; D006333:Heart Failure / Q000208:ethnology / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D017180:Tachycardia, Ventricular / Q000150:complications / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D016387:Women's Health
D002317:Cardiovascular Agents